Effects of Self-curing Activator and Curing Protocol on

the Bond Strength of Composite Core Buildups

Andreas Rathkea/Ulrike Balzb/Rainer Muchec/Bernd Hallerd

Purpose: To determine the effect of the polymerization mode of simplified bonding systems and the corresponding core buildup resin composite on the bond strength to dentin.
Materials and Methods: Composite core buildups were bonded to flat prepared dentin surfaces of 320 human
molars using a two-step etch-and-rinse (Excite, ER) and a two-step self-etching (AdheSE, SE) bonding system.
Bonding systems were used both with and without their respective self-curing activators (Excite DSC, ER+SC; AdheSE DC, SE+SC). Six curing protocols for the dual-curing composite (MultiCore Flow) were examined: self-curing
for 5 min (a); irradiation with light from each aspect for 10 s (b), 20 s (c), and 40 s (d); and irradiation with light
from the occlusal aspect only for 60 s (e) and 120 s (f). Shear bond strengths were measured immediately after
curing. Additional measurements were performed after water storage of the specimens for 24 h at 37C. These
specimens had been cured according the curing protocols given in the manufacturers instructions (groups a and
d). Failure modes were analyzed using scanning electron microscopy.
Results: Immediate bond strengths were significantly different among the bonding systems (p < 0.001): SE >
ER > ER+SC > SE+SC. Immediate bond strengths of ER and SE were significantly lower when the composite was
self-cured (p < 0.05). The use of SC activators reduced the bond strength and promoted adhesive failures to
dentin. A severe incompatibility problem was observed between the composite and SE+SC.
Conclusion: Dentin bonding of dual-curing composite core buildups in combination with simplified bonding systems is still unsatisfactory, even when SC activators are employed. For adequate bonding to dentin, polymerization of the dual-curing composite should always be light initiated.
Keywords: self-curing activator, bonding system, composite core buildup, curing protocol, incompatibility, bonding effectiveness.
J Adhes Dent 2012; 14: 3946.
doi: 10.3290/j.jad.a21541

ual-curing (DC) resin composite core buildups combine the advantages of light curing (fast initial
polymerization of the surface layer) and self curing
(chemically induced polymerization in deeper areas).

Assistant Professor, Department of Operative Dentistry and Periodontology,

University of Ulm, Ulm, Germany. Study design, statistical analysis, wrote
manuscript.

Dentist in private practice, Eislingen/Fils, Germany. Performed experiments

in partial fulfillment of requirements for Dr. med. dent. degree.

Professor and Acting Director, Institute of Biometry, University of Ulm, Ulm,

Germany. Consulted on statistical evaluation.

Professor and Director, Department of Operative Dentistry and Periodontology, University of Ulm, Ulm, Germany. Contributed substantially to idea,
study design, and testing hypothesis.

Correspondence: Dr. Andreas Rathke, University of Ulm, Department of Operative Dentistry and Periodontology, Albert-Einstein-Allee 11, 89081 Ulm,
Germany. Tel: +49-731-50064155, Fax: +49-731-50064102.
e-mail: andreas.rathke@uniklinik-ulm.de

Vol 14, No 1, 2012

Submitted for publication: 12.07.09; accepted for publication: 13.01.11

Bulk application of DC composites is a time-saving procedure when compared to the incremental application of
light curing (LC) composites.25 However, studies have
demonstrated that self-curing (SC) and DC composites
are not adequately polymerized when they come in
direct contact with the air-inhibited layer produced by
simplified bonding systems with pH < 3,2,6,22,24 such as
two-step etch-and-rinse (ER) and self-etching (SE) bonding systems.9,16,29,30 Their incompletely cured acidic
monomers neutralize the composites tertiary amine catalyst (Lewis base), which together with the initiator (benzoyl peroxide) forms the binary, redox curing system.22
Since radical polymerization is not catalyzed by protonated amine (ammonium), the conversion rate of SC
composites which come in contact with acidic bonding
systems is low. The same mechanism may cause the
auto-curing reaction of DC composites to fail.9,29,30,32
Some bonding systems designed for light curing have
been supplemented with a self-curing activator,1,7,18,32 not
only in order to ensure complete polymerization in deeper
39

Rathke et al

Table 1 Bonding systems studied

Code

Bonding system
(batch No)

Composition
(pH)

Mode of application

ER

Excite
(H31177)

HEMA, DMA, phosphonic acid acrylate, silicon

dioxide, initiators, stabilizers, ethanol (pH 1.7)

Etch and rinse. Apply with light scrubbing motion

(10 s), gently air dry (3 s), light cure (20 s)

ER+SC

Excite DSC
(G14423)

Like that of Excite; microbrush is additionally

coated with initiators (pH 1.7)

Etch and rinse. Apply with light scrubbing motion

using the microbrush coated with initiators (10 s),
gently air dry (3 s)

SE

AdheSE
(H33433)

Primer: phosphonic acid acrylate,

DMA, initiators, stabilizers, water (pH 1.7)
Bonding agent: HEMA, DMA, silicon dioxide,
initiators, stabilizers (pH 7.0)

Primer: Apply with light scrubbing motion (30 s),

air dry (3 s)
Bonding agent: Apply a thin layer, light cure (10 s)

SE+SC

AdheSE DC
(H33433)

Like that of AdeSE; additionally DC Activator:

initiators, ethanol (pH 9.2)

Primer: Apply with light scrubbing motion (30 s),

air dry (3 s)
Bonding agent: Mix with DC Activator in equal
amounts, apply the mixture, gently air dry (3 s)

Product information according to the manufacturer. DMA, dimethacrylate; HEMA, 2-hydroxyethyl methacrylate.

parts of the cavity, but also to prevent potential chemical

incompatibility with SC and/or DC composites (ie, acidbase reaction). Most of the contemporary SC activators
contain salts of aromatic sulphinic acids, which presumably react with the uncured acidic monomers in a redox
reaction for the generation of free radicals.5,23,26,32 They
may also promote polymerization by scavenging oxygen,
thereby producing thinner air-inhibited layers with fewer
acidic monomers.22,23 However, it has been reported that
dentin bonding of SC and DC composites depends on the
chemical composition of the individual bonding system
and is not necessarily enhanced by including a SC activator in the bonding procedure.4,10,16 Simplified bonding systems contain hydrophilic acidic monomers which
are strongly hypertonic after polymerization.17,20,26,31
The polymerized adhesive layer forms a semi-permeable
membrane through which dentin fluid can diffuse into the
composite, driven by osmosis if no hydrophobic adhesive is applied to act as an intermediate barrier.3,4,11,13
Osmotic diffusion results in the formation of water-filled
channels referred to as water trees and blisters, which
pass from the hybrid layer across the adhesive layer and
into the adhesive/composite interface.5,13 Exuded water
droplets are trapped by the overlying composite, resulting
in honeycomb-like resin structures when the composite
is self-cured or cured with delayed light activation.27,28
Entrapped residual water may decrease the interfacial
mechanics, thus compromising bonding quality and durability.14
Another factor that may influence bond strength is
the amount of light passing through the composite core
buildup to reach the adhesive/composite interface. Some
DC composites do not reach their maximum depth of
polymerization, because chemical polymerization cannot properly compensate for inadequate light curing if
the composite is not cured long enough.12,25 It would be
expected that inappropriate simplification of light-curing
40

protocols could compromise the dentin bonding of DC

composite core buildups, even when the respective SC
activators are employed.
Based on the observation that components of bonding
systems can inhibit the polymerization of composites, and
that the manner of curing the materials could affect their
compatibility, the purpose of the study was to evaluate the
bond strength of a core buildup composite as influenced
by (1) simplified bonding systems which were characterized by different modes of conditioning (etch-and-rinse vs
self-etching) and curing (light curing vs self-curing) and
(2) various curing protocols differing in the light direction
and/or irradiation time of the DC composite. The following
null hypotheses were tested: (1) The adjunctive use of an
SC activator with the bonding system does not improve
the bond strength to dentin, and (2) the bond strength
remains the same when the composite is bonded using
different curing protocols.

MATERIALS AND METHODS

Specimen Preparation
Three hundred twenty sound human molars were selected from a stock of extracted teeth. The teeth were
stored in a 1% chloramine T solution at 4C from the
time of extraction until preparation. After separation of
the crowns 2 to 3 mm coronally to the cementoenamel
junction using a water-cooled diamond separating disk
(Woco 50/Med, Conrad; Clausthal-Zellerfeld, Germany),
the exposed mid-depth dentin was ground flat using a
sequence of 600- and 800-grit silicon carbide papers
under running water in a polishing machine (Woco SF
20, Conrad). After visual examination of the exposed
dentin surfaces for remnants of enamel, caries, or pulp
exposure, the teeth were placed with the flat dentin
surfaces facing down on a glass plate laminated with
The Journal of Adhesive Dentistry

Rathke et al

Application opening for

the composite
Split jig
Transparent mold
Dentin surface
Acrylic resin
Brass mold
Bottom of split jig

Fig 1 Schematic representation of

specimen preparation.

double-sided adhesive tape (Tesa; Hamburg, Germany).

Brass molds open on both sides were placed over the
teeth in such a way that the dentin surface was in the
center of the mold. After embedding of the teeth in
acrylic resin (Technovit 4071, Kulzer; Wehrheim, Germany), the adhesive tape was removed and the dentin
surfaces were polished wet on 800-grit silicon carbide
paper. The embedded teeth were randomly divided into
four groups (n = 80) according to one of the following
bonding systems: a light-curing two-step etch-and-rinse
system (Excite), its dual/self-curing analogue (Excite
DSC), a light-curing two-step self-etching system (Adhese), and the latter in combination with its corresponding activator (Adhese DC). The bonding systems (Ivoclar
Vivadent; Schaan, Liechtenstein) are characterized in
Table 1. When the bonding procedure involved phosphoric acid etching, a 37% phosphoric acid gel (Total
Etch, batch No: G00869, Ivoclar Vivadent) was applied
to the dentin for 15 s and rinsed off with water for 20 s.
Gross excess water was removed with short air blasts,
leaving a moist dentin surface.
For standardized placement of composite cores, the
brass molds with the embedded teeth were positioned in
a split jig with a counter screw pressing the dentin surface
against a cylindrical plexiglass mold measuring 5 mm in
height and having an inner diameter of 3.9 mm (Fig 1).
The dual-curing core buildup composite MultiCore Flow
(shade light; batch No: J03032, Ivoclar Vivadent) was
filled into the transparent molds using an automixing syringe. In each bonding system group, the specimens were
randomly divided into eight subgroups (n = 10) according
to different curing protocols for the core buildups and
different time periods between polymerization and shear
testing (Table 2). When the curing protocols included light
activation of the composite, the core buildup was initially
exposed to light from the occlusal aspect. After loosening
of the counter screw and removal of the specimen from
Vol 14, No 1, 2012

Counter screw

Table 2 Subgroups studied for each bonding system

Subgroup
(n = 10)

Curing protocol of
the composite core
buildup

Interval between
polymerization
and shear testing

Self-curing

Allow to self-cure for

5 min*

Immediately

5 x 10 s

Light cure from each of

5 aspects for 10 s**

Immediately

5 x 20 s

Light cure from each of

5 aspects for 20 s **

Immediately

5 x 40 s

Light cure from each of

5 aspects for 40 s *

Immediately

60 s

Light cure from the occlusal aspect for 60 s**

Immediately

120 s

Light cure from the occlusal aspect for 120 s**

Immediately

Self-curing

Allow to self-cure for

5 min*

24 h

5 x 40 s

Light cure from each of

5 aspects for 40 s*

24 h

* as recommended by the manufacturer; ** deviating from the manufacturers recommendation.

the split jig, the core buildup was light irradiated from the
remaining four aspects (buccal, oral, mesial, and distal)
depending on the respective curing protocols. In order to
prevent initiation of the polymerization reaction by ambient light, all filling and curing procedures were performed
in a room exclusively lit by a red bulb with a wavelength of
> 520 nm (No 712, Philips; Eindhoven, the Netherlands).
41

Rathke et al

Fig 2 SEM micrographs of failure modes (1000X magnification). (a) Type I: Adhesive failure between the adhesive layer and the
composite core, indicated by composite remnants on the surface. (b) Type II: Adhesive failure between the adhesive layer and the
dentin, indicated by remnants of resin tags inside the dentinal tubules. (c) Type III: Cohesive failure in the adhesive layer. No remnants of composite were identified on the surface. (d) Type IV: Cohesive failure in the dentin, indicated by dentinal tubules not occluded with resin tags. (e) Type V: Cohesive failure in the composite core, where the adhesive layer has not been exposed.

All light-curing procedures were performed with a halogen

light-curing unit (Spectrum Curing Light, Dentsply DeTrey;
Konstanz, Germany) which was regularly checked for a
minimum light intensity of 650 mW/cm2.
Shear Bond Strength Test
Shear bond strengths were measured immediately after
polymerization of the composite core buildup and additionally after 24 h of water storage at 37C for the
two curing protocols recommended by the manufacturer
(Table 2). Shear testing was conducted according to
ISO/TS 11405:2003 Dental materials Testing of adhesion to tooth structure. The specimens were secured
in a mounting jig that was positioned on the table of a
universal testing machine (Zwicki 1120, Zwick Roell;
Ulm, Germany) with a 200-kg load cell (class 0.05). A
steel knife-edged chisel aligned parallel at a distance
of 0.5 mm from the bonding interface was used to load
the composite core at a crosshead speed of 0.5 mm/
min until failure. Bond strengths were calculated as
the ratio of the load at fracture and the bonding area
(11.95 mm2) using a materials testing software program
(testXpert, version 7.0, Zwick Roell).
Statistical Analysis
Since the data were not normally distributed, they
were analyzed using non-parametric tests (KolmogorovSmirnov test, p = 0.012). The Kruskal-Wallis test was
employed to detect significant effects of bonding systems and curing protocols on the dentin bond strength
42

(p < 0.05). Subsequent pairwise comparisons between

subgroups were performed with the Mann-Whitney test.
The resulting p values were corrected for multiple comparisons according to the Bonferroni-Holm procedure.
Differences were accepted as significant when the adjusted p value was less than 0.05. All statistical tests
were calculated with the statistics software SPSS for
Windows, version 14.0 (SPSS; Munich, Germany).
Scanning Electron Microscopy
The fractured surfaces of all specimens were prepared
for examination under the scanning electron microscope
(SEM). In order to distinguish between exposed dentin
and areas coated with resinous material (ie, adhesive,
composite), the fractured surfaces were etched with
34.5% phosphoric acid (Vococid, batch No 641588,
Voco; Cuxhafen, Germany) for 60 s. After rinsing with
water and air drying for 24 h at ambient temperature
(20C to 25C), the fractured surfaces were sputter
coated with gold using a conductive voltage of 15 to
20 mA for 2 min (Emitech K 550, Rntgenanalytik
Messtechnik; Taunusstein, Germany) and analyzed
under the SEM (Leica Stereoscan 420, LEO-Elektronenmikroskopie; Oberkochen, Germany). One investigator
(U.B.) estimated the fractional area of each failure mode
from the SEM micrographs and expressed this data as
a percentage of the total bonding area of each fractured
surface. The failures were categorized according to a
modified classification system based on Tay et al 27
(Fig2).
The Journal of Adhesive Dentistry

Rathke et al
Self curing

MPa

5 10 s

30

5 20 s

25

5 40 s
60 s

B
C

20

120 s

B
B

15

B
A

10

A
B

AB

ER

ER+SC

SE

SE+SC

Fig 3 Box plots of immediate bond strengths. The box represents the data between the lower and upper quartile. The thin line represents the median and the bold line the mean value. The whiskers extend to the minimum and maximum value. In each bonding
system group, significant differences according to the Holm-adjusted Mann-Whitney test (p < 0.05) are marked by different letters.
Bonding system codes are explained in Table 1. Curing protocol codes are explained in Table 2.

Table 3 Median, mean, minimum and maximum values of 24-h bond strengths
in MPa

ER

ER+SC

SE

SE+SC

Median

Mean

Minimum

Maximum

Self-curing

10

13.7

14.1

11.1

19.1

5 x 40 s

10

23.3

21.8

7.5

34.4

Self-curing

10

10.2

10.6

7.8

15.6

5 x 40 s

10

15.9

18.5

12.3

35.7

Self-curing

10

5.1

6.0

0.5

13.0

5 x 40 s

10

27.7

27.6

7.4

45.2

Self-curing

10

7.1

7.3

3.1

12.9

5 x 40 s

10

7.9

7.8

0.3

12.1

Codes are explained in Tables 1 and 2.

RESULTS
The results of the bond strength measurements are
summarized in Fig 3. The Kruskal-Wallis test indicated
significant effects of the bonding systems (p < 0.001)
on both the immediate and the 24-h bond strengths.
The following ranking was determined in terms of highest-to-lowest immediate bond strengths: SE > ER >
ER+SC > SE+SC (where > denotes a significantly
higher value at p < 0.05). In each bonding system
group, significant differences were observed among the
six curing protocols (p < 0.001).
When the composite core buildups were self-cured,
neither LC nor SC bonding systems achieved considerVol 14, No 1, 2012

able immediate bond strengths. Bond strengths of ER and

SE significantly increased when the composite was light
cured (p < 0.05). With ER+SC, such an increase in bond
strength was only achieved when the composite core was
light cured from all five aspects (p < 0.05). When using
SE+SC, neither self-curing nor light curing the composite core resulted in notable immediate bond strengths.
Considering the bond strengths after 24-h water storage,
SE+SC achieved significantly lower values than ER and
ER+SC, respectively (p < 0.001). No significant differences in 24-h bond strengths were found between the
other bonding systems (Table 3).
The failure modes are summarized in Fig 4. When the
composite core was self-cured, ER and SE failed pre43

Rathke et al

Type I

Type II

Type III

Type IV

Type V

Self curing
5 10 s
5 20 s
5 40 s
60 s
120 s
24-h
percentages:
Self curing
5 40 s
0%

20%

40%

60%

80%

100% 0%

20%

ER

40%

60%

80%

ER+SC

100% 0%

20%

40%

60%

80%

SE

100% 0%

20%

40%

60%

80%

100%

SE+SC

Fig 4 Proportional prevalence of the failure modes. Type I: Adhesive failure between the adhesive layer and the composite core;
Type II: Adhesive failure between the adhesive layer and the dentin; Type III: Cohesive failure in the adhesive layer; Type IV: Cohesive failure in the dentin; Type V: Cohesive failure in the composite core. Bonding system codes are explained in Table 1. Curing
protocol codes are explained in Table 2.

Fig 5 SEM micrographs of fractured surfaces. (a) Type I failure with porosities on the
surface. A honeycomb-like appearance with numerous resin beads can be observed
along the interface between Excite and the self-cured MultiCore (6000X magnification). (b) Failure at the interface between AdheSE and the self-cured MultiCore. Note
the remnants of composite on the surface, which indicate a Type I failure (250X magnification). (c) Failed specimen bonded with Excite DSC and self-cured MultiCore. The
dentinal tubules were mostly occluded by resin tags, which indicates a Type II failure
(1500X magnification). (d) Failed specimen bonded with AdheSE DC and MultiCore
after light-curing the composite core buildup. The remnants of resin tags inside the
dentinal tubules indicate a Type II failure (1500X magnification).

dominantly between the adhesive layer and the composite

core (Figs 5a and 5b). In contrast, the ER+SC and SE+SC
specimens showed adhesive failures mainly between the
adhesive layer and the dentin (Fig 5c). After light curing
the composite core, the failure pattern of ER and SE was
a mixture of several types of failure. When ER+SC and
SE+SC were used, most of the specimens failed between
the adhesive layer and the composite core or between the
adhesive layer and the dentin (Fig 5d).
44

DISCUSSION
This study examined the bond strength to dentin of twostep bonding systems with different modes of conditioning (etch-and-rinse vs self-etching) and curing (light curing
vs self-curing) in combination with a DC core buildup
composite. The selection of materials was based on
the results of previous studies indicating that simplified
bonding systems and composites of different commerThe Journal of Adhesive Dentistry

Rathke et al

cial brands may be chemically incompatible2,10,16 and

that the best results are achieved when all the products
used in the adhesive restorative procedure are from
the same manufacturer.15,19 The common way to study
the compatibility of bonding systems and composites
is bond strength testing.2,22,27,29,30 However, the bond
strength as the outcome variable is influenced by several
well-known factors, such as the unavoidable variability
between the teeth, the remaining dentin thickness, and
the variability in the bonding procedure. In this study, attempts were made to minimize such variation by using
standardized dentin-surface preparation and having the
same operator (U.B.) produce and test all the specimens.
The coefficient of variation of the bond strength results
ranged from 16% to 40%, with the exception of the subgroups in which the bond strength was close to the detection limit of the testing assembly.
Self-curing of the DC core buildup composite (MultiCore
Flow) compromised the immediate bond strength. This result is in agreement with a previous report, which found low
dentin bond strengths for Excite and AdheSE in combination with a SC composite.16 In comparison to LC composites, the longer pre-gel phase of the self-cured MultiCore
allows the molecules to diffuse into and react with the slowsetting composite. For uncured acidic monomers, diffusion
distances of 7.7 m, 11 m, 15.5 m, and 21.9 m were
calculated when curing of the composite was conducted
with a delay of 2.5, 5, 10, and 20 min, respectively.27
Apart from the time interval of this interaction, the acidity
of the bonding system also affects the bond strength of
SC composites.22 In the presence of organophosphate
monomers, complete inhibition of the self-curing reaction
was observed.26 Such organic phosphoric compounds are
contained in both Excite (ca 11% w/w) and the AdheSE
Primer (ca 40% w/w) in the form of phosphonic acid acrylate. The adhesive failures, which were only observed in the
SEM between Excite and self-cured MultiCore, may indicate
both chemical and physical incompatibility.
Despite the use of an intermediate, solvent-free, pH
neutral adhesive layer, AdheSE also produced extremely
low bond strengths. Furthermore, 82% adhesive failures to
the self-cured MultiCore were recorded. A possible explanation could be the high content of hydrophilic monomers
in the AdheSE Bonding agent (ca 23% w/w HEMA). The
results obtained with AdheSE paralleled the findings of a
recent report on the use of two-step SE systems with relatively hydrophilic adhesives (AdheSE, Clearfil SE Bond),
in which the dentin bond strength of a SC composite was
significantly lower than that of a LC composite.16 Although
hydrophobic dimethacrylates are contained in the adhesive, the hydrophillic monomers tend to cluster prior to
polymerization, thus creating hydrophilic domains through
which water can penetrate from the underlying dentin to
the adhesive/composite interface.17,28 Another explanation could be the thickness of the air-inhibited layer, which
significantly increases with the concentration of HEMA in
monomer blends.8 This may further compromise polymerization and promote the absorption of acidic monomers
through AdheSE Primer into the overlying AdheSE Bonding
agent. In this instance, the more hydrophobic and thus
Vol 14, No 1, 2012

less permeable adhesives have demonstrated better sealing capability.3,11,13

The effect of SC activators on the dentin bond strength
of bonding systems has been discussed contentiously.
According to some authors, bonding to SC and DC composites can be enhanced by the incorporation of an activator.22,29,30 However, recent studies have also shown that
the efficacy of the self-activated reaction seems to be material dependent.1,7,18 In the present study, the inclusion of
the respective SC activator was not effective in improving
the bond with the self-cured MultiCore. When using SC
bonding systems, specimens failed predominantly at the
adhesive/dentin interface (Excite DSC 94%, AdheSE DC
100%). This can be explained by several factors. First, the
SC activators need an additional initiator component contained in the MultiCore composite for initiating chemical
polymerization. The use of the SC bonding systems without
any separate light curing prevented the generation of an immediate dentin bond which could resist the polymerization
shrinkage of the composite.12 As a consequence, the DC
composite was applied to an unpolymerized adhesive layer.
Second, the formulation of the original light-curing AdheSE
Bonding agent required the unfilled and solvent-containing
AdheSE Activator to be mixed with it at a 1:1 ratio, which
probably diluted the monomers, the fillers, and the photoinitiator as well. Finally, the AdheSE Activator contains ca
80% w/w ethanol. If residual amounts of the alcoholic solvent are not completely evaporated, they could affect resin
polymerization inside the hybrid layer or at least occupy
space that optimally should have been filled with resin.18,23
In contrast, Excite DSC uses a special microbrush whose fibers are impregnated with the activator to avoid the diluting
effect by another solution. However, Excite DSC is less viscous than Excite. We suspect that the Excite DSC layer was
too thin to withstand the polymerization shrinkage stress of
the composite23 and/or was displaced laterally during the
composite application, leaving a sparsely filled coating (ca
0.5% w/w filler content) in some dentin areas.4,20,21 As a
result of the debonding along the dentin, dentinal tubules
may be left uncovered.
Immediate light-curing of the DC composite significantly
increased the bond strength of both LC bonding systems.
This finding is in agreement with the results of previous
studies.9,16,22,24 DC composites utilize photochemical redox systems that also involve the use of tertiary amines.
However, due to light activation, the formation of free radicals in photochemical redox reactions is much faster than
in SC composites.22,24 Therefore, the competition for nucleophiles between the two reactions is in favor of the
generation of free radicals, and the acid-base reaction is
probably suppressed.22 Light irradiation of the composite
core buildups from all aspects tended to yield higher bond
strengths than irradiation exclusively from the occlusal aspect, indicating an increased depth of polymerization.
According to the results of this study, the use of simplified bonding systems in combination with their SC activators adversely affected the bond strength to dentin of a DC
core buildup composite. Since self-curing of Excite DSC
and AdheSE DC is only initiated in contact with MultiCore,
it could be assumed that the retention of water from
45

Rathke et al

osmotic diffusion is higher in the SC bonding systems

than in the corresponding LC versions. The very low bond
strength of AdheSE DC (even after 24-h water storage)
resulted in a high number of pre-test failures on the dentin
side. While this could point to the conclusion that AdheSE
DC inhibits the light curing effectiveness of MultiCore, the
mechanisms behind this inhibition effect cannot be identified on the basis of the present results.

CONCLUSIONS
The first null hypothesis was confirmed, because the
inclusion of SC activators in their respective bonding
systems did not improve the bond strength to dentin. On
the contrary, the SC activators may interfere with lightcuring of the composite. The second null hypothesis
had to be rejected because dentin bonding was compromised when the DC composite was not light cured. For
adequate bonding to dentin, polymerization of DC composite core buildups should always be light initiated.

ACKNOWLEDGMENTS
The authors wish to thank Henry Frehse for his kind assistance
with scanning electron microscopy and Gaby Wachter for graphics
support. The authors also acknowledge Susanne Fuchs for language editing this paper.

REFERENCES
1. Arrais CA, Giannini M, Rueggeberg FA. Effect of sodium sulfinate salts
on the polymerization characteristics of dual-cured resin cement systems exposed to attenuated light-activation. J Dent 2009;37:219-227.
2. Bolhuis PB, De Gee AJ, Kleverlaan CJ, El Zohairy AA, Feilzer AJ. Contraction stress and bond strength to dentin for compatible and incompatible
combinations of bonding systems and chemical and light-cured core
build-up resin composites. Dent Mater 2006;22:223-233.
3. Brackett WW, Ito S, Tay FR, Haisch LD, Pashely DH. Microtensile dentin
bond strength of self-etching resins: effect of a hydrophobic layer. Oper
Dent 2005;30:733-738.
4. Chang J, Platt JA, Yi K, Cochran MA. Quantitative comparison of the
water permeable zone among four types of dental adhesives used with
a dual-cured composite. Oper Dent 2006;31:346-353.
5. Cheong C, King NM, Pashley DH, Ferrari M, Toledano M, Tay FR. Incompatibility of self-etch adhesives with chemical/dual-cured composites:
two-step vs one-step systems. Oper Dent 2003;28:747-755.
6. Endo T, Finger WJ, Hoffmann M, Kanehira M, Komatsu M. The role of
oxygen inhibition of a self-etch adhesive on self-cure resin composite
bonding. Am J Dent 2007;20:157-160.
7. Faria-e-Silva AL, Casselli DS, Lima GS, Ogliari FA, Piva E, Martins LR.
Kinetics of conversion of two dual-cured adhesive systems. J Endod
2008;34:1115-1118.
8. Finger WJ, Lee KS, Podszun W. Monomers with low oxygen inhibition as
enamel/dentin adhesives. Dent Mater 1996;12:256-261.
9. Giannini M, De Goes MF, Nikaido T, Shimada Y, Tagami J. Influence of
activation mode of dual-cured resin composite cores and low-viscosity
composite liners on bond strength to dentin treated with self-etching
adhesives. J Adhes Dent 2004;6:301-306.
10. Hagge MS, Lindemuth JS. Shear bond strength of an autopolymerizing
core buildup composite bonded to dentin with 9 dentin adhesive systems. J Prosthet Dent 2001;86:620-623.
11. Hashimoto M, Tay FR, Ito S, Sano H, Kaga M, Pashely DH. Permeability of adhesive resin films. J Biomed Mater Res B Appl Biomater
2005;74:699-705.

46

12. Hikita K, Van Meerbeek B, De Munck J, Ikeda T, Van Landuyt K, Maida

T, Lambrechts P, Peumans M. Bonding effectiveness of adhesive luting
agents to enamel and dentin. Dent Mater 2007;23:71-80.
13. King NM, Tay FR, Pashley DH, Hashimoto M, Ito S, Brackett WW,
Garca-Godoy F, Sunico M. Conversion of one-step to two-step self-etch
adhesives for improved efficacy and extended application. Am J Dent
2005;18:126-134.
14. Koshiro K, Inoue S, Sano H, De Munck J, Van Meerbeek B. In vivo degradation of resin-dentin bonds produced by a self-etch and an etch-andrinse adhesive. Eur J Oral Sci 2005;113:341-348.
15. Latta MA, Kelsey WP, Kelsey WP. Effect of polymerization mode of
adhesive and cement on shear bond strength to dentin. Am J Dent
2006;19:96-100.
16. Moll KH, Schuster B, Haller B. Dentin bonding of light- and self-curing
resin composites using simplified total- and self-etch adhesives. Quintessence Int 2007;38:41-49.
17. Nishitani Y, Yoshiyama M, Hosaka K, Tagami J, Donnelly A, Carrilho M,
Tay FR, Pashley DH. Use of Hoys solubility parameters to predict water
sorption/solubility of experimental primers and adhesives. Eur J Oral
Sci 2007;115:81-86.
18. Nunes TG, Erhardt MC, Toledano M, Osorio R. One-step self-etching
adhesive polymerization: influence of a self-curing activator. J Dent
2009;37:616-621.
19. OKeefe KL, Powers JM. Adhesion of resin composites core materials to
dentin. Int J Prosthdont 2001;14:451-456.
20. zok AR, Wu MK, De Gee AJ, Wesselink PR. Effect of dentin perfusion
on the sealing ability and microtensile bond strengths of a total-etch
versus an all-in-one adhesive. Dent Mater 2004;20:479-486.
21. Sadek FT, Calheiros FC, Cardoso PE, Kawano Y, Tay FR, Ferrari M. Early
and 24 hour bond strength and degree of conversion of etch-and-rinse
and self-etch adhesives. Am J Dent 2008;21:30-34.
22. Sanares AM, Itthagarun A, King NM, Tay FR, Pashley DH. Adverse surface interactions between one-bottle light-cured adhesives and chemical-cured composites. Dent Mater 2001;17:542-556.
23. Say EC, Nakajima M, Senawongse P, Soyman M, zer F, Tagami J.
Bonding to sound vs caries-affected dentin using photo- and dual-cure
adhesives. Oper Dent 2005;30:90-98.
24. Shafiei F, Safarpoor I, Moradmand M, Alavi AA. Effect of light activation
mode on the incompatibility between one-bottle adhesives and lightcured composites: an in vitro shear bond strength study. Oper Dent
2009;34:558-564.
25. Stavridakis MM, Kakaboura AI, Krejci I. Degree of remaining C=C bonds,
polymerization shrinkage and stresses of dual-cured core build-up resin
composites. Oper Dent 2005;30:443-452.
26. Suh BI, Feng L, Pashley DH, Tay FR. Factors contributing to the incompatibility between simplified-step adhesives and chemically-cured
or dual-cured composites. Part III. Effect of acidic resin monomers. J
Adhes Dent 2003;5:267-282.
27. Tay FR, King NM, Pashley DH. Effect of delayed activation of light-cured
resin composites on bonding of all-in-one adhesives. J Adhes Dent
2001;3:207-225.
28. Tay FR, Pashley DH. Have dentin adhesives become too hydrophilic? J
Can Dent Assoc 2003;69:726-731.
29. Tay FR, Pashley DH, Yiu CK, Sanares AM, Wei SH. Factors contributing
to the incompatibility between simplified-step adhesives and chemicallycured or dual-cured composites. Part I. Single-step self-etching adhesive. J Adhes Dent 2003;5:27-40.
30. Tay FR, Suh BI, Pashely DH, Prati C, Chuang SF, Li F. Factors contributing to the incompatibility between simplified-step adhesives and
self-cured or dual-cured composites. Part II. Single-bottle, total-etch
adhesive. J Adhes Dent 2003;5:91-105.
31. Van Landuyt KL, Snauwaert J, De Munck J, Coutinho E, Poitevin A, Yoshida Y, Suzuki K, Lambrechts P, Van Meerbeek B. Origin of interfacial
droplets with one-step adhesives. J Dent Res 2007;86:739-744.
32. Van Landuyt KL, Snauwaert J, De Munck J, Peumans M, Yoshida Y,
Poitevin A, Coutinho E, Suzuki K, Lambrechts P, Van Meerbeek B.
Systematic review of the chemical composition of contemporary dental
adhesives. Biomaterials 2007;28:3757-3785.

Clinical relevance: Light curing of the dual-curing

composite is essential, even when self-curing bonding systems are employed. As a safeguard, it is
advisable to light cure dual-curing composite core
buildups from each aspect in order to improve the immediate bond strength to dentin.

The Journal of Adhesive Dentistry

Copyright of Journal of Adhesive Dentistry is the property of Quintessence Publishing Company Inc. and its
content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's
express written permission. However, users may print, download, or email articles for individual use.